Dentaltown November 2015 - (Page 46)

pediatric dentistry feature by Josh Wren, DMD Space Maintenance: The Right Appliance at the Right Time O One of the most common questions asked on the Dentaltown pediatric dentistry message boards is, "Do I need to place a space maintainer here? If I do need a space maintainer, which one do I need?" My goal of this article is to address those two questions. Ask any orthodontist the following question: "Is it easier to put the teeth where they need to be if you have the space available, or is it easier to create the space first then put the teeth where they need to go?" The following examples are general examples only. There are often other variables that can influence the use of a particular space maintainer. Missing "d" Missing "e" Six-year molar fully erupted and in occlusion: No space maintainer needed Six-year molar not erupted: Distal shoe or no space maintainer (distal shoes are an advanced space maintainer procedure and not necessarily the standard of care-no space maintenance is a possible option). Fig. 1 "d" needs to be extracted but six-year molar is fully erupted Distal shoes must be followed radiographically at each recall appointment. The blade portion that contacts the mesial of the six-year molar usually needs to be shortened once or twice before the six-year molar is fully erupted. A "d" is a primary first molar-tooth #'s B, I, L or S Six-year molar not erupted, or not fully erupted: Band and loop is indicated An "e" is a primary second molar-tooth #'s A, J, K, or T Fig. 3a Distal shoe-a pre-cementation radiograph is a must Fig. 2a Band and loop is indicated until the six-year molar is fully erupted Fig. 3b Blade location is close but not ideal Fig. 2b Band and loop has maintained the "d space" and can now be removed Fig. 3c Blade location is ready for cementation 46 NOVEMBER 2015 //

Table of Contents for the Digital Edition of Dentaltown November 2015

HOWARD SPEAKS: Avoid a Perfect Storm: Focus on Infection Control
PROFESSIONAL COURTESY: Suffering from Arithmophobia?
Continuing Education Update
Industry News
Check Out This Broken Implant
Disaster Case— Hail Mary
Internal Marketing Begets Referrals
When to Refer to a Periodontist
Parents in the Operatory: Friend or Foe?
What You Need to Know to Hire the Perfect Hygienist
Space Maintenance: The Right Appliance at the Right Time
Practice Solutions: AMD LASERS
Practice Solutions: Planmeca
Product Profi le:
Adhesives: 60 Years of Clinical and Chemical Improvement
Product Profi le: DEXIS
Misaligned Anterior Teeth Straightened with Direct Composite Bonding
Five Common Web Design Mistakes
You’re a Public-Health Dentist and You Didn’t Even Know It!
Retirement Planning Made Simple
Young Patient Redefi nes the Face of Dentures
New Products
Healthy Mouth, Healthy Body: A Patient Info Sheet
Ad Index
You Should Know: Synergy Dental Partners
Practice Growth Fueled by Technology
The Clinical Algorithms of Rehabilitation
Dentally Incorrect

Dentaltown November 2015